With the focus on relationships in Mental Health Week, NHS England has put the spotlight on Sheffield where they are helping nurture relationships between adopters, foster carers and children to improve their adoption outcomes and mental health.
Almost 50 adopted children have had a smoother transition to their new homes thanks to a fresh £85,000 scheme in Sheffield helping assess and support their mental health needs.
The Pre-Adoption Service, run by Sheffield Children’s NHS Foundation Trust, hosted a successful unique year-long trial to reduce the number of failed adoptions and children needing mental health services in the future.
As well as funding the process of adopting a child, further therapeutic interventions can cost thousands and should a young person develop a problem requiring inpatient care, the average cost for a mental health inpatient CAMHS stay is £640 per day (NHS England source).
The child’s adopter is helped to understand the potential psychological needs of the child, a service not usually offered before transition from foster home to adopter.
During a special meeting a clinical psychologist advises the social workers, foster carer and adopters involved how to plan best to positively affect the child’s mental health.
Dr Alex Espejo, Consultant Clinical Psychologist, said: “We have been so successful because we have very good working relationship with the local authority. They let us know the complete list of children, then we’ve been able to make sure the meeting to discuss their needs and transition plans happen.
“It’s all about relationships and improving the relationships between the foster carers, the child, the social worker, and the adopters. We want to get families off on the right foot.”
Before the service launched, any child thought to have a severe mental health issue would have been referred to services in the usual way. However, many young children in care would not have been seen to need this and would not have any psychological input. As they grow older their difficulties can increase if their adoptive parents do not know how to help them. Now all children ready for adoption have their mental health needs considered or identified.
Before the child’s transition plan is finalised an average of three meetings takes place and the psychologist advises on the best process.
“It’s a difficult area to evaluate but what we do know is that often when adoption relationships break down the transition process has been in some way difficult.
“It could be that the foster carer found it hard to let go or the child was having difficulty adjusting to the idea. But by having these extra discussions we’re able to pre-empt any issues and make sure the transition is the best plan for the child,” Dr Espejo added.
Dr Jackie Cornish, National Clinical Director for Children, Young People and Transition to Adulthood, said: “This exciting initiative shows how we can work together to meet the needs of vulnerable children and young people, intervening early to give them the best chance in life. Sheffield’s joined up approach shows what can be achieved with a modest investment to deliver a huge impact for individual children, their future families and services.”
An example is informal meetings between the adopters and the child on home turf or in the park by chance without mention of adoption may be suggested.
It may concern the timing of conversations about adoption or with siblings and each child’s need is different and must be considered individually, particularly if the child has been with the foster family a long time.
Therapeutic interventions post placement can support the adoption to be successful and give the child the best opportunity to reach their potential. Adopters after this service have more of an understanding of what they and their child, or children, may need from therapy services.
Feedback on the programme showed that 99.5 per cent of carers and 100 per cent of professionals felt listened too, and 97 per cent and 98 per cent of carers and professionals respectively felt able to talk about what they wanted to in the consultation meetings.
99 per cent of carers and 100 per cent of professionals felt they understood what was being talked about in the meeting and 95.5 per cent of carers and 97 per cent of professionals felt the meeting gave them ideas about what to do.
Training to staff and prospective adopters around attachment, trauma and therapeutic re-parenting has also been provided.
The scheme will run again next year and further evaluation will be done to monitor children who have been through the first year.